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首页> 外文期刊>Annals of epidemiology >Is the obesity epidemic reversing favorable trends in blood pressure? Evidence from cohorts born between 1890 and 1990 in the United States
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Is the obesity epidemic reversing favorable trends in blood pressure? Evidence from cohorts born between 1890 and 1990 in the United States

机译：肥胖病流行会逆转血压的有利趋势吗？来自1890年至1990年在美国出生的队列的证据

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Background: Previous reports have described favorable changes in the relationship between systolic blood pressure and age in recent birth cohorts. The obesity epidemic might threaten that pattern. Objectives: To update analyses of differences between birth cohorts in the relationship between systolic blood pressure and age and to determine whether increases in obesity have had adverse effects. Methods: We examined the systolic blood pressure distributions across birth cohorts born between 1890 and 1990 in 68,070 participants, aged 18-74 years, in the National Health (and Nutrition) Examination Surveys between 1960 and 2008. We postulated that age-adjusted 10th, 25th, 50th, 75th, and 90th percentiles of systolic blood pressure had decreased in more recent versus earlier cohorts, and that this pattern had slowed or reversed recently due, at least in part, to obesity. Results: After adjusting for gender, race, age and age 2, the 10th, 25th, 50th, 75th, and 90th percentiles of systolic blood pressure were 1.1, 1.4, 1.9, 2.5, and 3.4 mmHg lower for each decade more recently born (all P .0001). Quadratic terms for birth cohort were positive and significant (P .001) across all percentiles, consistent with a decelerating cohort effect. Mediation of this deceleration was observed for body mass index ranging from 20.4% to 44.3% (P .01 at all percentiles). Conclusions: More recent cohorts born in the United States between 1890 and 1990 have had smaller increases in systolic blood pressure with aging. At any age, their systolic blood pressure distributions are shifted lower relative to earlier cohorts. Decreases of 1.9 mmHg in the median systolic blood pressure per decade translates into 11.4-13.3 mmHg over 6-7 decades, a shift that would contribute importantly to lower rates of cardiovascular diseases. These favorable changes are slowing, perhaps owing, at least in part, to the obesity epidemic.
机译：背景：先前的报道描述了最近出生队列中收缩压与年龄之间关系的有利变化。肥胖病的流行可能威胁到这一模式。目的：更新出生队列之间收缩压与年龄之间关系的差异分析，并确定肥胖症的增加是否有不良影响。方法：我们在1960年至2008年的“全国健康（和营养）检查调查”中检查了8070名年龄在18-74岁的参与者中，1890年至1990年出生的队列中收缩压的分布情况。与较早的队列相比，较近期的队列收缩压的第25、50、75和90％降低了，并且至少部分由于肥胖，这种模式最近有所减慢或逆转。结果：在对性别，种族，年龄和年龄2进行调整后，最近出生的每十年，收缩压的第10、25、50、75和90％分别降低1.1、1.4、1.9、2.5和3.4 mmHg（所有P <.0001）。在所有百分位数中，出生队列的二次项均为阳性且显着（P <.001），与队列效应的降低一致。体重指数在20.4％至44.3％的范围内观察到了这种减速的中介作用（所有百分位数的P <0.01）。结论：1890年至1990年之间在美国出生的新近队列中，随着年龄的增长，收缩压的升高幅度较小。在任何年龄段，他们的收缩压分布都比早期人群低。每十年收缩压中位数下降1.9 mmHg会在6至7年内转化为11.4-13.3 mmHg，这一变化将对降低心血管疾病的发生率做出重要贡献。这些有利的变化正在减缓，至少部分是由于肥胖病的流行。

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